Breaking Down Post-Dates Research
Originally published at Sacred Pathways Doula Services. Please leave any comments there.
A woman sits in her doctors office at 40 weeks, anxiously waiting for her doctor to come in. After 15 minutes or more in she or he comes, glancing at the chart before greeting the woman by name. “Well, baby isn’t here yet. I doubt she/he will come on his own. Shall we go ahead and schedule an induction for next Wednesday?” There may have been some mild chatting of how she is feeling, taking babies heartbeat, a vaginal exam, etc before this whopper is laid out.
Perhaps the doctor and woman talk about the risks versus the benefits, perhaps not. I hear a lot of women talking about how their doctor’s say, “Going past 41 weeks is dangerous for the baby. The placenta can degenerate and your baby can die.” And while for some women this may hold true, we and our babies are not all created from the same mold. Our nutrition during pregnancy plays a roll as does our family history, ethnicity, and other personal factors. But when a doctor says these things, they routinely are referring to this study; Crowley P. Interventions for preventing or improving the outcome of delivery at or beyond term. (Cochrane Review). In: The Cochrane Library. Issue 2. Oxford: Update Software, 2002. (Abstract)
While this does look like a great study there are sadly flaws to be found. These flaws are pointed out in fairly easy to read language by Henci Goer. What if I were to tell you that the systematic review was flawed because the original studies themselves were flawed? That sort of puts a moot point on the study. Not to mention that if we look at Europe, where the maternal and fetal outcomes are much better than our own on average, we see they wait till 42 or 43 weeks to induce. So what commentary am I referring too by Henci Goer? Why this one.
Now comes the question of what to do with the information. Often times when the word, ‘Induction’ comes up it is at a time where women can’t even imagine changing providers. This is totally understandable! This is a person you have developed a relationship with over the pregnancy and had the expectation will be present at the birth. Thankfully if you have a truly trusting and good relationship you should be able to sit down with Henci Goer’s commentary printed out and discuss it. Hopefully the two of you can come to an understanding and you and your baby will get the time to finish developing.